title: Fetal macrosomia greater than or equal to 4000 grams. Comparing maternal and neonatal outcomes in diabetic and nondiabetic women.
abstract: OBJECTIVE
  To compare maternal and neonatal outcomes of fetal macrosomia in diabetic and nondiabetic women.
  
  
  METHODS
  A retrospective case-control study was conducted at Riyadh Military Hospital, Riyadh, Kingdom of Saudi Arabia from January 2004 to December 2006. A total of 766 macrosomic newborns met the inclusion criteria. We compared maternal and neonatal characteristics and outcomes between diabetic (group 1, n=207) and nondiabetic (group 2, n=559) women.
  
  
  RESULTS
  There were significantly more macrosomic newborns in nondiabetic women; 73% versus 27% in diabetic women, p=0.0001. Cesarean deliveries were significantly higher in diabetic women compared to nondiabetic women (30.4% versus 19.5%, p=0.002). There were no significant differences between either group in total maternal morbidity (12.6% versus 14.1%, p=0.7). There were significantly more severe cases of shoulder dystocia occurring in newborns of diabetic women compared to nondiabetic women (1.9% versus 0.2%, p=0.03).
  
  
  CONCLUSIONS
  Elective cesarean delivery for estimated fetal weight > or =4500g for nondiabetic women and > or =4250 g for diabetic women may avoid severe shoulder dystocia without increasing maternal morbidity rates.
authors.affiliation: Department of Obstetrics and Gynecology, Riyadh Military Hospital, Riyadh, Kingdom of Saudi Arabia. drsaleh99@yahoo.com
authors.forename: Ahmed
authors.initials: A
authors.lastname: Saleh
authors.forename: Sultan M
authors.initials: SM
authors.lastname: Al-Sultan
authors.forename: Anwar M
authors.initials: AM
authors.lastname: Moria
authors.forename: Fatema I
authors.initials: FI
authors.lastname: Rakaf
authors.forename: Yasmin M
authors.initials: YM
authors.lastname: Turkistani
authors.forename: Shaha H H
authors.initials: SH
authors.lastname: Al-Onazi
mesh_terms: D000328:Adult; D036861:Delivery, Obstetric / Q000379:methods; D016640:Diabetes, Gestational / Q000453:epidemiology; D004420:Dystocia / Q000453:epidemiology / Q000517:prevention & control; D005260:Female; D005320:Fetal Macrosomia / Q000453:epidemiology; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D011247:Pregnancy; D011256:Pregnancy Outcome; D011254:Pregnancy in Diabetics / Q000453:epidemiology; D012189:Retrospective Studies; D012529:Saudi Arabia / Q000453:epidemiology